Time Trends, Regional Variability and Seasonality Regarding the Incidence of Type 1 Diabetes Mellitus in Romanian Children Aged 0-14 Years, Between 1996 and 2015

Vlad, Adrian; Şerban, Viorel; Green, Anders; Möller, Sören; Vlad, Mihaela; Timar, Bogdan; Sima, Alexandra

doi:10.4274/jcrpe.5456

Cited by 9 publications

(12 citation statements)

References 25 publications

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“…The highest number of cases continues to be diagnosed in the older 10–14‐year age category in our population, and a number of other populations who have a similar incidence of T1DM to Ireland also show this trend, particularly Norway and Australia 2,10,24 . Some centres have shown the number of cases and incidence rates in the younger age categories are increasing suggesting a shift to an earlier age at diagnosis 6,12,13 . We have not found this.…”

Section: Discussionsupporting

confidence: 45%

“…In Ireland, the highest rates of T1DM have been predominately in the older 10–14 year age category to date 4,9 . This trend was seen in a number of other high incidence countries, such as Norway, 2 Australia, 10 Spain 1 and Canada, 11 while others report the highest increases in children aged under 5 years, such as Poland, 6 Hungary 12 and Romania 13 . Recent research has shown that countries with a lower overall incidence rates of T1DM have had a faster rise in T1DM incidence particularly in children aged under 5 years 12,13 .…”

Section: Introductionmentioning

confidence: 94%

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Incidence of childhood type 1 diabetes mellitus in Ireland remains high but no longer rising

McKenna

O’Regan

Ryder³

et al. 2021

Acta Paediatrica

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Aim The global incidence of type 1 diabetes mellitus (T1DM) varies considerably geographically. Ireland has a high incidence of T1DM. Incidence accelerated between 1997 and 2008, although more recent data (2008–2013) suggested stabilisation in the incidence rate (IR). This study sought to determine IRs for 2014 to 2018. Methods Incident cases were prospectively recorded through the established Irish Childhood Diabetes National Register (ICDNR). Cases were verified, and IRs were calculated. Capture‐recapture methodology was identical to previous studies. Age and seasonality data were compared. Results A total of 1429 cases were reported (age range 0.45–14.98 years), with significantly more males (772, 54%) and male‐to‐female ratio of 1.17 (95% CI 1.05, 1.29). Standardised IRs for T1DM in the period were 28.0; 29.6; 30.9; 27.0; and 27.1/100,000/year, respectively. There was a slight reduction in standardised IR, more marked in females than males (9.9% v 1.6%). The highest IR remains in the 10‐ to 14‐year‐old age group (44% of total cases). Seasonality of diagnosis is persistently higher in autumn and winter. Conclusion Ireland remains a high incidence country, despite a minor reduction in incidence rates. Ongoing incidence monitoring through national registers is vital to inform healthcare services, research relating to aetiology and paediatric diabetes management.

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Section: Discussionsupporting

confidence: 45%

Section: Introductionmentioning

confidence: 94%

Incidence of childhood type 1 diabetes mellitus in Ireland remains high but no longer rising

McKenna

O’Regan

Ryder³

et al. 2021

Acta Paediatrica

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“…In a three-year-long Dutch study including 676 children diagnosed with T1DM per year, the annual incidence rates per hundred thousand children were 6.6 and 6.4 in winter as opposed to 4.9 in spring and 5.4 in summer (p < 0.03) 19 . In 5422 children diagnosed with T1DM in Romania between 1996 and 2015, the maximum monthly incidence value was recorded in January (more than 450) as opposed to the minimum value recorded in June (around 300, p < 0.001) 20 . In 2174 Polish children diagnosed with T1DM between 2010 and 2014, the odds of diagnosis being made between June and August was 57% (95% confidence intervals: 51% to 67%, p < 0.0001) of the odds of diagnosing the disease between December and February 21 .…”

Section: Discussionmentioning

confidence: 90%

Inverse association between use of broad spectrum penicllin with beta-lactamase inhibitors and prevalence of type 1 diabetes mellitus in Europe

Ternák

Berényi

Kun

et al. 2021

Sci Rep

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Increasing incidence of type 1 diabetes is supposed to be induced by environmental factors. Microbiome modulated by antibiotics seems to serve as one of the environmental factors which could influence the development of T1DM. Mitochondria, as autochthonous environmental bacteria living in our cells, and other bacteria share many common enzymes including beta-lactamases and it is supported by evidence that some beta-lactamase inhibitors are able to interact with counterpart enzymes. Thus, antibiotics may utilize two different pathways influencing the development of T1DM; one through modulation of microbiome and a second one via the interaction of mitochondrial enzymes. Data of consumption of penicillin (both narrow and broad spectrum) and beta-lactamase inhibitors in 30 European countries were collected from the database of the European Centre for Disease Prevention and Control. These data were correlated with the prevalence reported by the International Diabetes Federation (2019) referring to type 1 diabetes in Europe. No correlation was found between total penicillin consumption or use of broad spectrum penicillin and the prevalence of type 1 diabetes. Nevertheless, broad spectrum penicillin, in combination with beta-lactamase inhibitor, was in inverse correlation with the prevalence of type 1 diabetes (r = − 0.573, p = 0.001). On the other hand, narrow spectrum penicillin was in positive correlation with type 1 diabetes (r = 0.523, p = 0.003). Prevalence of type 1 diabetes showed an inverse correlation with the use of beta-lactamase inhibitors and a positive one with that of narrow spectrum penicillin. Such a detailed analysis has not so far been provided referring to the penicillin group. In the background of this association either microbiomal or direct mitochondrial effects can be supposed.

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“…In addition to these mechanisms, viral infections [37] and/or vitamin de ciency [38] may also be involved. This seasonality is re ected in the high incidence rate of type 1 [37,39] and T2DM [40,41] during the coldest months. In agreement with previous ndings [36], the MAP at admission was signi cantly higher the present T2DM cohort in January than July over the 12-year study period (Table S2).…”

Section: Discussionmentioning

confidence: 99%

Seasonal Changes in Incidence of Patients With Diabetes Undergoing Cardiac Surgery

Kovács¹,

Peták²,

Agócs³

et al. 2020

Preprint

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Background: To evaluate the monthly incidence rate of patients with diabetes requiring heart surgery at a tertiary-care university hospital in East-Central Europe with a temperate climate zone. We also assessed whether additional factors affecting small blood vessels (smoking, aging, and diabetes) modulate the seasonal variability of diabetes.Methods: Medical records were retrospectively analyzed for all 9837 consecutive adult patients who underwent surgery at our institution between 2007 and 2018. Individual seasonal variations of diabetes, smoking, and elderly patients were analyzed monthly. Potential additive or subtractive effects of the coexistence of these factors in seasonal changes in incidence rates were also examined. In the absence of a waiting list, incidence rates accurately reflect the frequency of exacerbation of cardiovascular symptoms requiring surgical intervention.Results: Significant seasonal variations in the monthly incidence rate of diabetes (p < 0.02), smoking (p < 0.001), and elderly (p < 0.001) patients were observed at the cardiac surgery unit. The peak incidence of non-elderly and smoking patients with diabetes was during winter, whereas heart surgery in elderly patients without diabetes and smoking was most frequently required in summer. Concomitant occurrence of diabetes and smoking had an additive effect on the relative incidence rate of requirement for cardiac surgery (p < 0.001), while the simultaneous presence of older age and diabetes or smoking eliminated seasonal variations.Conclusions: Scheduling regular cardiovascular control in accordance with periodicities in diabetes, elderly, and smoking patients more than once a year may improve patient health and social consequences.Trial registration: NCT03967639

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Time Trends, Regional Variability and Seasonality Regarding the Incidence of Type 1 Diabetes Mellitus in Romanian Children Aged 0-14 Years, Between 1996 and 2015

Cited by 9 publications

References 25 publications

Incidence of childhood type 1 diabetes mellitus in Ireland remains high but no longer rising

Incidence of childhood type 1 diabetes mellitus in Ireland remains high but no longer rising

Inverse association between use of broad spectrum penicllin with beta-lactamase inhibitors and prevalence of type 1 diabetes mellitus in Europe

Seasonal Changes in Incidence of Patients With Diabetes Undergoing Cardiac Surgery

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